Impact of multiple intubation attempts on adverse tracheal intubation associated events in neonates: a report from the NEAR4NEOS

• Published in: Journal of perinatology 2022-09, Vol.42 (9), p.1221-1227
• Main Authors: Singh, Neetu, Sawyer, Taylor, Johnston, Lindsay C., Herrick, Heidi M., Moussa, Ahmed, Zenge, Jeanne, Jung, Philipp, DeMeo, Stephen, Glass, Kristen, Howlett, Alexandra, Shults, Justine, Barry, James, Brei, Brianna K., Kim, Jae H., Quek, Bin Huey, Tingay, David, Mehrem, Ayman Abou, Napolitano, Natalie, Nishisaki, Akira, Foglia, Elizabeth E.
• Format: Article
• Language: English
• Subjects: 692/308/409; 692/499; Desaturation; Humans; Infant, Newborn; Intubation; Intubation, Intratracheal - adverse effects; Medicine; Medicine & Public Health; Neonates; Newborn babies; Oxygen; Pediatric Surgery; Pediatrics; Registries; Retrospective Studies
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/s41372-022-01484-5

Objective To determine the relationship between number of attempts and adverse events during neonatal intubation. Study design A retrospective study of prospectively collected data of intubations in the delivery room and NICU from the National Emergency Airway Registry for Neonates (NEAR4NEOS) in 17 academic centers from 1/2016 to 12/2019. We examined the association between tracheal intubation attempts [1, 2, and ≥3 (multiple attempts)] and clinical adverse outcomes (any tracheal intubation associated events (TIAE), severe TIAE, and severe oxygen desaturation). Results Of 7708 intubations, 1474 (22%) required ≥3 attempts. Patient, provider, and practice factors were associated with higher TI attempts. Increasing intubation attempts was independently associated with a higher risk for TIAE. The adjusted odds ratio for TIAE and severe oxygen desaturation were significantly higher in TIs with 2 and ≥3 attempts than with one attempt. Conclusion The risk of adverse safety events during intubation increases with the number of intubation attempts.